OBJECTIVETo observe the acupoint distribution and clinical efficacy of lumbar disc herniationi (LDH) with different sensitive types.

METHODSEighty patients with LDH were randomly divided into a heat-sensitive moxibustion group (group A), a heat-sensitive acupuncture group (group B), a force-sensitive acupuncture group (group C) and a force-sensitive moxibustion group (group D), 20 cases in each one. In the group A and the group B, moxibustion and acupuncture were applied at two or three heat-sensitive acupoints separately. In the group C and the group D,acupuncture and moxibustion were used at two or three force-sensitive acupoints respectively. The treatment was given once a day, totally 10 times. The distribution law of the heat-sensitive acupoints and the force-sensitive acupoints and the change of M-JOA before and after treatment were recorded in the four groups.

RESULTSThe frequent heat-sensitive acupoints areas of LDH were at Yaoyangguan (GV 3), Dachangshu (BL 25), Zhiyang(GV 9), Guanyuanshu(BL 26) and Weizhong(BL 40). The major force-sensitive acupoints areas were at Shenshu (BL 23), Dachangshu (BL 25), Tianshu (ST 25), Guilai (ST 29) and Weizhong (BL 40). After treatment, the heat-sensitive acupoints in the group A and the group B were all reduced than those before treatment and the force-sensitive acupoints in the group C and the group D were declined as well (P < 0.01, P < 0.05). The M-JOA scores were obviously lower than those before treatment in the four groups (all P < 0.01). The score in the group A was reduced more apparently than that in the group B (P < 0.05). The score in the group C was declined more markedly than that in the group D (P < 0.05).

CONCLUSIONThere are diverse acupoints for LDH patients due to different sensitive types. All forms of stimulation can change the functional state of acupoints. Moxibustion is more suitable for heat-sensitive acupoints and acupuncture is optimal for force-sensitive acupoints.

Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Aged ; Female ; Humans ; Intervertebral Disc Displacement ; therapy ; Male ; Middle Aged ; Moxibustion ; methods ; Treatment Outcome

Objective: To elucidate the key effects of moxibustion points and quantity of moxibustion used in order to enhance the curative effect of moxibustion therapy. Methods: It analyzed the occurrence rules of acupoint heat-sensitization and its relationship to the moxibustion location and dose, in view of the original definition of acupoints in Nei Jing (Internal Canon) and the acupoint heat-sensitization in clinical practice. Results: (1) The original definition of acupoint is the reflecting area of a disease on surface of the body, which is individualized, motive and sensitive; (2)The location in which heat-sensitization is generated relating to a heat-sensitive acupoint, which therefore depicts the best choice for point selection and also the most accurate area to give moxibustion; (3) The heat-sensitization time can be taken as a clinical index to quantify the moxibustion dose, in order to apply sufficient moxibustion for each individual. Conclusion: The key points for enhancing the curative effect of moxibustion therapy are to identify heat-sensitive points and a scientific moxibustion dose.

Objective To observe the effects of heat-sensitive moxibustion on the expression and activity of super-oxide dismutase (SOD) and the content of malondialdehyde (MDA) in focal cerebral ischemia-reperfusion injury in rats, and the mechanism thereof. Methods Thirty-six male SD rats were randomly divided into four groups, sham-operated group (n=6), ischemia-reperfusion (I/R) injury group (n=10), I/R injury with 15-minute moxibustion group (n=10) and I/R injury with 35-minute moxibustion group (n=10). The focal cerebral ischemia-reperfusion rat model was induced by middle cere-bral artery occlusion (MCAO) for 2 h followed by reperfusion. Values of SOD activity and MDA content were determined by colorimetry, and the cortical expression of SOD2 protein was detected by Western blot technique. Results Values of SOD activities were significantly higher in serum (22.78±1.31)U/mL and cortex (4 909.6±1 345.6) U/g of heat-sensitive moxibus-tion group than those of model group (20.17±1.12)U/mL and (2 602.0±1 515.5)U/g. Values of MDA contents were significant-ly decreased in serum (3.78±2.00)μmol/L and cortex (1 226.5±38.4)nmol/g in heat-sensitive moxibustion group than those of model group (16.82 ± 6.70)μmol/L and (1 905.6 ± 478.6) nmol/g. The cortical expression of SOD2 protein (0.974 ± 0.166) was higher in heat-sensitive moxibustion group than that of model group (0.702±0.040). Conclusion Heat-sensitive moxi-bustion could reduce the damage of cerebral inchemia-reperfusion, which might be through improving SOD activity, increas-ing SOD expression and decreasing MDA content.

Objective To observe the effect of moxibustion pretreatment on caspase-3 expression in cortex of rats with cerebral ischemia-reperfusion injury. Methods Twenty-one male SD rats were randomly divided into three groups, sham group (n=6), model group (n=8) and moxibustion pretreatment group (n=7). Focal cerebral ischemia-reperfusion injury rat model was induced by middle cerebral artery occlusion (MCAO) for 2 hours followed by reperfusion. Brain infarct was ex-amined by TTC staining. Brain morphology was shown by HE staining and the ultrastructure of cell was observed with elec-tron microscope. Caspase-3 expression in cortex was examined by immunofluorescence histochemistry. Results The per-centage of infarct volume [(24.9±4.7)%] in moxibustion pretreatment group was much smaller than that [(45.8±4.6)%] in mod-el group. Nerve cells in moxibustion pretreatment group experienced less morphological and structural changes than those in model group, and caspase-3 positive cells (39.17 ± 7.28) in moxibustion pretreatment group were less than those (58.17 ± 16.53) in model group. Conclusion Moxibustion pretreatment could attenuate cerebral ischemia-reperfusion injury, which might be through decreasing caspase-3 expression.

Objective To observe apoptotic cells and caspase-3-positive cells in ipsilateral neonatal hypoxic-isch?emia encephalopathy (NHIE) model in mice. Methods CD1 mice of age 7 days (n=30) were randomly divided into two groups: sham group (n=9) and model group (n=21). NHIE model was induced by right common carotid artery ligation fol?lowed by 8%oxygen hypoxia for 100 min. TTC staining was used to determine area of brain infarction. DAPI staining was used to detect pathological change in brains. TUNEL assay was used to detect apoptotic cells and fluorescence immunohisto?chemistry was used to detect caspase-3 expression in the ipsilateral brain. Results No infarct was detected in sham group. Cells were densely and orderly arranged in brain. TUNEL-positive cells (18.57±4.98) and caspase-3-positive cells (9.17± 2.14) in the ipsilateral brain were both less than those in the ipsilateral brain of mice in model group (209.57±41.27) and (63.33±16.22) respectively. Mice in model group presented infarct in the right hemisphere with more dead cells and wider in?terstitial space compared with sham group. Conclusion Brain injury in NHIE model might be related to the increasing cas?pase-3 expression thus leads to apoptosis.

ObjectiveTo compare the clinical effect of heat-sensitive moxibustion before menstruation and since the first day of menstruation on primary dysmenorrhoea （PD）， thereby optimizing the clinical treatment plan. MethodsSixty patients with PD were randomly divided into pretreatment group （treated before menstruation） and conventional treatment group （treated since the first day of menstruation） of 30 cases each. For all patients， the area surrounded by bilateral Zigong （EX-CA1） and bilateral Guilai （ST 29） in the supine position， and that formed by bilateral Shenshu （BL 23） and Ciliao （BL 32） in the prone position were selected for circling moxibustion （2 min）， sparrow-pecking moxibustion （1 min）， and then moxibustion along the channels to stimulate the moxibustion sensation and obtain two heat-sensitive points with the best sensation for treatment. In the pretreatment group， moxibustion was applied 3-7 days before the onset of menstruation， and in the conventional treatment group， moxibustion was applied on the day of menstruation. Both groups were treated once daily for 7 days per menstrual cycle for 3 consecutive cycles. The clinical outcomes of the two groups were measured before and after treatment in terms of the COX menstrual pain symptom scale （CMSS） scores， visual analogue scale for pain （VAS） scores， and uterine artery hemodynamic indicators including blood pulsation index （PI） and resistance index （RI）， and the clinical effect was compared. ResultsAfter treatment， the CMSS scores， VAS scores， PI and RI in the two groups decreased， and lower scores were found in the pretreatment group （P＜0.05 or P＜0.01）. The total effective rate after treatment was 93.3% （28/30） in the pretreatment group， which was better than 73.3% （22/30） in the conventional treatment group （P＜0.05）. ConclusionThe clinical effect of heat-sensitive moxibustion before the menstruation for PD was better than that implemented since the first day of menstruation， by significantly improving the patients' dysmenorrhoea symptoms and uterine artery blood flow index.

OBJECTIVETo observe the effects of heat-sensitive moxibustion on corticotropin releasing hormone (CRH), adrenocorticotrophic hormone (ACTH) and corticosterone (CORT) in rats with irritable bowel syndrome (IBS), and to explore the possible mechanism of heat-sensitive moxibustion on IBS.

METHODSAccording to random number table, 56 SD male rats were randomly divided into a blank group (=8), a model group (=8), a moxibustion group (=32), and a mifepristone group (RU-486 group,=8). The rats in the blank group were treated with normal feeding; the rats in the model group, RU-486 group and moxibustion group were treated with chronic non-predictable stimulation for 21 days to establish IBS model. After model establishment, the rats in the moxibustion group were treated with moxibustion at "Mingmen" (GV 4) for 40 min, once a day for 14 days; the tail temperature was recorded every 5 min; according to the change of tail temperature, the rats were divided into a heat-sensitive moxibustion group and a non-heat-sensitive moxibustion group, and 8 rats were randomly selected in the two groups. The rats in the RU-486 group were treated with gastric administration of RU-486 for 14 days, while the rats in the blank group, model group and moxibustion groups were treated with identical volume of 0.9% NaCl. The rat general condition, body mass, behavioristics, intestinal propulsive rate and visceral sensitivity were observed in each group; ELISA method was used to detect serum CRH, ACTH and CORT; optical microscope was applied to observe the morphological changes of colon.

RESULTS(1) After model establishment, rats were in rest state, fatigued, with withered hair and dim ear; the stool was dry or watery; the body mass were slowly increased; the number of crossed grid and standing frequency were significantly reduced; visceral sensitivity was increased and intestinal propulsion rate was decreased; no obvious inflammatory cell infiltration was observed under microscope. (2) After intervention, compared with the blank group, the body mass and visceral sensitivity in the RU-486 group were not significantly different (both>0.05), but the intestinal propulsion rate was decreased significantly (<0.01). Compared with the blank group, the body mass of heat-sensitive moxibustion group and non-heat-sensitive moxibustion group was lower (both<0.01), but the visceral sensitivity and intestinal propulsion rate were similar (both>0.05). Compared with the model group, the body mass and visceral sensitivity were improved in the RU-486 group (<0.05,<0.01), but the intestinal propulsion rate was similar (>0.05). The body mass, visceral sensitivity and intestinal propulsion rate of the heat-sensitive moxibustion group and the non-heat-sensitive moxibustion group were superior to those of the model group (<0.05,<0.01), and the body mass and intestinal propulsion rate of heat-sensitive moxibustion group were superior to those of non-heat-sensitive moxibustion group (both<0.05). (3) After intervention, compared with the blank group, the contents of CRH, ACTH and CORT in the model group were significantly increased (<0.05,<0.01). Compared with the model group, the contents of CRH, ACTH and CORT of the heat-sensitive moxibustion group were statistically reduced (<0.05,<0.01), and the contents of CRH and ACTH in the non-heat-sensitive moxibustion group were statistically reduced (<0.05,<0.01); the content of CRH in the RU-486 group was reduced (<0.05), but the contents of ACTH and CORT were increased (<0.05,<0.01). Compared with the non-heat-sensitive moxibustion group, the heat-sensitive moxibustion group was better in the improvement of CRH (<0.05), but there was no significant difference of ACTH and CORT between the two groups (both>0.05).

CONCLUSIONHeat-sensitive moxibustion could reduce the contents of CRH, ACTH and CORT through the HPA axis, and improve the function of gastrointestinal motility to treat IBS.